Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC004572L | PA |
NPI | 1942450655 |
---|---|
Provider Name | Mrs. Kirstin P Mink |
First Address | Elizabethtown, PA 17022-2422 |
Second Address | Elizabethtown, PA 17022-2422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 30/09/2008 |